Forensic Nurses Treat Victims Where Health Care And Law Intersect


They’re called sexual assault nurse examiners, trained to treat and comfort victims who are struggling through the most painful, traumatic time of their life. These specialized nurses see it all and hear it all.

“Some things in our job we can’t un-hear, we can’t un-see,” said Michelle Resendez, a registered forensic nurse and coordinator for Franciscan Health in Crown Point.

SANE nurses, as they’re called, also testify in court about their medical findings, if needed, either helping to prosecute or exonerate a suspect while serving as a voice for victims of sexual assault, child abuse, elder abuse or traumatic attacks.

“It’s where health care and the law intersect,” Resendez said.

Forensic nursing is the application of health care in the legal investigation of trauma or death related to abuse, violence, criminal acts, liability or accidents. It’s stressful and emotional work. Most victims reporting the crime two or three days after it occurred.

“Too many victims wrongly feel they were somehow to blame,” said Lori Bridegroom, a SANE nurse coordinator for Franciscan Health’s campus in Michigan City.

“We all have this idea that sexual assault victims are cute girls in shorts who are jogging down the street and pulled behind the bushes. This isn’t what typically happens,” she said. “It’s usually someone the victim knows, or someone they love.”

Some patients feel shame. Some feel emotional torture. Some feel they won’t be believed. When Bridegroom started working at Franciscan Health in 2010, these sensitive cases were handled by whichever nurse was available, not by accredited SANE nurses with continual training.

“This practice has evolved, at least at our facilities, since that time,” she said.

Michelle Resendez, Lori Bridegroom, and Sara Montalbano, from left to right, are forensic nurses at Franciscan Health, program coordinators for sexual assault nurse examiners. (Franciscan Health / Post-Tribune)

When Sara Montalbano was a young girl, she dreamed of becoming either a cop, a doctor or a teacher. Never a nurse.

“Being a SANE nurse allows me to be a part of all of these professions in the same job,” said Montalbano, a SANE nurse coordinator for Franciscan Health’s campuses in Hammond, Munster and Dyer.

Franciscan Health started this program in 2012 at all six of its campuses across Northwest Indiana. Its caseload is increasing. Last year, the hospital system handled 200-plus cases, with even more cases not reported as a patient’s “chief complaint.” A state fund pays for the medical treatment of all sex crime victims, per state statute.

“Victims will approach me to share their story once they find out that I’m a sexual assault nurse examiner,” Montalbano said.

I met with the three nurses at the hospital system’s Crown Point campus to learn about their caseloads, their frustrations and their love for what they do.

“I have always been fortunate that during the roughest times in my life, someone has always been there to offer a kind word, a friendly smile, or sometimes just an ear to listen,” Bridegroom said. “It is because of those people I was able to pick myself up and move on. Being a SANE nurse, I have the opportunity to be that person.”

Franciscan Health’s SANE nurses treat patients in its Centers of Hope, designated spaces where victims are given one-on-one trauma care. The Crown Point campus offers a five-day intensive SANE adult/adolescent training course that instructs nurses to provide trauma-informed, victim-centered care, injury identification, evidence preservation, forensic photography and documentation.

“We had to learn how to mirror patients to best understand them and what they’re going through,” Montalbano said. “They can tell if you’re faking it.”

They can’t just barge into an examining room and demand answers. They also must be aware of acute and long-term effects of sexual violence. Some patients are discreetly provided with a sticker they can place on a urine sample to quietly let staff know they are a victim of human trafficking.

“We had one victim who came in with a stab wound to the back of her neck, but it wasn’t until after the entire triage process when a SANE nurse later learned that she was as a victim of human trafficking,” Resendez said.

The woman had physical wounds on her legs from being chained to a floor.

Franciscan’s program provides community outreach, working with law enforcement agencies and sexual assault response teams in Lake and LaPorte counties. It also works with advocacy organizations, including Fair Haven Rape Crisis Center in Highland. Its founder, Kelly Vates, has been a champion for sexual assault victims since I’ve been writing about these cases.

One SANE nurse had to testify in court under the pressure of cross-examination on the witness stand. She conducted herself brilliantly. After she left the courtroom, she turned to Resendez and told her, “Michelle, I quit. This job is just too stressful. I can’t ever do this again.”

Not all nurses can be SANE nurses.

Franciscan Health houses the Centers of Hope, designated spaces where sexual assault and child abuse victims are given one-on-one trauma care, including at its Crown Point campus pictured here. (Franciscan Health / Post-Tribune)

Less than a decade ago, local hospitals, law enforcement agencies, advocacy groups and prosecutor’s offices didn’t merge their information and efforts about these sensitive cases.

“None of us were talking to each other,” Resendez said. “It was very challenging.”

These community partners are now interacting with more cooperation to try to fit together all the puzzle pieces of a case. Some cases linger for months before SANE nurse are asked to offer expert testimony in court. Other cases are still ongoing two or three years after the assault. These nurses would appreciate occasional updates from the prosecutor’s office. Such updates are rare to nonexistent.

“Whatever the outcome of a case, an update would at least show us that our work is not sitting in a dusty box somewhere,” Resendez said. “It validates what we’re doing.”

SANE nurses collectively wonder about the outcomes of thousands of patients and victims. What happened to that girl who was raped? Or that woman who was trapped in a human trafficking ring? Or about that old man abused by a caregiver?

“This is my latest favorite part of our job,” Bridegroom said.

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